HESI Pathophysiology 2025-2026 questions with
correct solutions
Which of the following best describes the pathophysiology of asthma?
a) Excessive mucus production in the airways leading to obstruction
b) Chronic inflammation and bronchoconstriction of the airways
c) Destruction of alveoli and decreased lung elasticity
d) Thickening and scarring of lung tissue leading to reduced compliance -
CORRECT-ANSWERS b) chronic inflammation and bronchoconstriction of the
airways
A patient with diabetes mellitus is experiencing polyuria, polydipsia, and
polyphagia. Which of the following pathophysiological mechanisms is primarily
responsible for these symptoms?
a) Hyperglycemia-induced osmotic diuresis
b) Decreased insulin production by the pancreas
c) Insulin resistance at the cellular level
d) Glycosylation of proteins leading to tissue damage - CORRECT-ANSWERS a)
hyperglycemia-induced osmotic diuresis
In a patient with congestive heart failure, which of the following
pathophysiological changes is most likely to occur initially as a compensatory
mechanism?
a) Activation of the renin-angiotensin-aldosterone system (RAAS)
b) Sympathetic nervous system stimulation
,c) Ventricular hypertrophy
d) Pulmonary vasoconstriction - CORRECT-ANSWERS b) sympathetic nervous
system stimulation
What is the primary pathophysiological mechanism underlying rheumatoid
arthritis?
a) Autoimmune destruction of joint cartilage and synovial membrane
b) Degeneration of articular cartilage due to mechanical stress
c) Accumulation of uric acid crystals in the joints
d) Excessive production of synovial fluid leading to joint effusion - CORRECT-
ANSWERS a) autoimmune destruction of joint cartilage and synovial membrane
Which of the following pathophysiological changes is characteristic of chronic
obstructive pulmonary disease (COPD)?
a) Destruction of alveoli and loss of lung elasticity
b) Inflammation and scarring of the pleura
c) Increased production of surfactant in the lungs
d) Constriction of bronchioles due to smooth muscle hypertrophy - CORRECT-
ANSWERS a) destruction of alveoli and loss of lung elasticity
What is the primary pathophysiological mechanism underlying ischemic stroke?
a) Blockage of cerebral blood vessels by a thrombus or embolus
b) Rupture of cerebral blood vessels leading to hemorrhage
c) Impaired cerebral perfusion due to systemic hypotension
d) Compression of cerebral tissue by a tumor or hematoma - CORRECT-ANSWERS
a) blockage of cerebral blood vessels by a thrombus or embolus
,Which of the following pathophysiological mechanisms is responsible for the
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development of chronic kidney disease (CKD)?
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a) Glomerular hyperfiltration and hypertrophy
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b) Immune-mediated destruction of renal tubules
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c) Obstruction of urinary flow due to kidney stones
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d) Progressive loss of nephrons and renal function over time - CORRECT-ANSWERS
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d) progressive loss of nephrons and renal function over time
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In a patient with type 2 diabetes mellitus, which of the following pathophysiological
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changes is primarily responsible for insulin resistance?
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a) Decreased secretion of insulin by pancreatic beta cells
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b) Impaired glucose uptake by peripheral tissues
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c) Hyperglycemia-induced inhibition of insulin receptor signaling
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d) Dysregulation of hepatic glucose production - CORRECT-ANSWERS b) impaired
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glucose uptake by peripheral tissues
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Which of the following pathophysiological mechanisms is associated with the
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development of peptic ulcer disease?
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a) Excessive production of gastric acid by parietal cells
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b) Impaired mucosal blood flow leading to ischemia
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c) Chronic inflammation and infection with Helicobacter pylori
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d) Dysfunction of the lower esophageal sphincter allowing reflux of gastric contents -
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CORRECT-ANSWERS c) chronic inflammation and infection with H. pylori
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What is the primary pathophysiological mechanism underlying Alzheimer's disease?
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, a) Accumulation of amyloid plaques and neurofibrillary tangles in the brain
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b) Degeneration of motor neurons in the spinal cord
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c) Impaired transmission of acetylcholine at the neuromuscular junction
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d) Blockage of cerebral blood vessels by thrombi or emboli - CORRECT-ANSWERS a)
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accumulation of amyloid plaques and neurofibrillary tangles in the brain
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What is the primary cause of cystic fibrosis?
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a) Autoimmune destruction of pancreatic beta cells
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b) Excessive production of mucus by bronchial glands
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c) Mutations in the CFTR gene leading to defective chloride ion transport
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d) Chronic exposure to tobacco smoke and environmental pollutants - CORRECT-
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ANSWERS c) mutations in the CFTR gene leading to defective chloride ion transport
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What is the primary pathophysiological mechanism underlying Parkinson's disease?
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a) Degeneration of dopaminergic neurons in the substantia nigra of the brain
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b) Impaired transmission of serotonin in the spinal cord
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c) Accumulation of tau protein aggregates in the cerebral cortex
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d) Blockage of cerebral blood vessels by atherosclerotic plaques - CORRECT-
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ANSWERS a) degeneration of dopaminergic neurons in the substantia nigra of the
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brain
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Which of the following pathophysiological mechanisms is associated with the
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development of osteoporosis?
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a) Excessive production of parathyroid hormone leading to bone resorption
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b) Decreased synthesis of collagen by osteoblasts
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c) Impaired blood supply to bone tissues causing necrosis
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correct solutions
Which of the following best describes the pathophysiology of asthma?
a) Excessive mucus production in the airways leading to obstruction
b) Chronic inflammation and bronchoconstriction of the airways
c) Destruction of alveoli and decreased lung elasticity
d) Thickening and scarring of lung tissue leading to reduced compliance -
CORRECT-ANSWERS b) chronic inflammation and bronchoconstriction of the
airways
A patient with diabetes mellitus is experiencing polyuria, polydipsia, and
polyphagia. Which of the following pathophysiological mechanisms is primarily
responsible for these symptoms?
a) Hyperglycemia-induced osmotic diuresis
b) Decreased insulin production by the pancreas
c) Insulin resistance at the cellular level
d) Glycosylation of proteins leading to tissue damage - CORRECT-ANSWERS a)
hyperglycemia-induced osmotic diuresis
In a patient with congestive heart failure, which of the following
pathophysiological changes is most likely to occur initially as a compensatory
mechanism?
a) Activation of the renin-angiotensin-aldosterone system (RAAS)
b) Sympathetic nervous system stimulation
,c) Ventricular hypertrophy
d) Pulmonary vasoconstriction - CORRECT-ANSWERS b) sympathetic nervous
system stimulation
What is the primary pathophysiological mechanism underlying rheumatoid
arthritis?
a) Autoimmune destruction of joint cartilage and synovial membrane
b) Degeneration of articular cartilage due to mechanical stress
c) Accumulation of uric acid crystals in the joints
d) Excessive production of synovial fluid leading to joint effusion - CORRECT-
ANSWERS a) autoimmune destruction of joint cartilage and synovial membrane
Which of the following pathophysiological changes is characteristic of chronic
obstructive pulmonary disease (COPD)?
a) Destruction of alveoli and loss of lung elasticity
b) Inflammation and scarring of the pleura
c) Increased production of surfactant in the lungs
d) Constriction of bronchioles due to smooth muscle hypertrophy - CORRECT-
ANSWERS a) destruction of alveoli and loss of lung elasticity
What is the primary pathophysiological mechanism underlying ischemic stroke?
a) Blockage of cerebral blood vessels by a thrombus or embolus
b) Rupture of cerebral blood vessels leading to hemorrhage
c) Impaired cerebral perfusion due to systemic hypotension
d) Compression of cerebral tissue by a tumor or hematoma - CORRECT-ANSWERS
a) blockage of cerebral blood vessels by a thrombus or embolus
,Which of the following pathophysiological mechanisms is responsible for the
ll ll ll ll ll ll ll ll ll
development of chronic kidney disease (CKD)?
ll ll ll ll ll ll ll
a) Glomerular hyperfiltration and hypertrophy
ll ll ll ll ll
b) Immune-mediated destruction of renal tubules
ll ll ll ll ll ll
c) Obstruction of urinary flow due to kidney stones
ll ll ll ll ll ll ll ll ll
d) Progressive loss of nephrons and renal function over time - CORRECT-ANSWERS
ll ll ll ll ll ll ll ll ll ll ll ll ll ll
d) progressive loss of nephrons and renal function over time
ll ll ll ll ll ll ll ll ll ll
In a patient with type 2 diabetes mellitus, which of the following pathophysiological
ll ll ll ll ll ll ll ll ll ll ll ll
changes is primarily responsible for insulin resistance?
ll ll ll ll ll ll ll ll
a) Decreased secretion of insulin by pancreatic beta cells
ll ll ll ll ll ll ll ll ll
b) Impaired glucose uptake by peripheral tissues
ll ll ll ll ll ll ll
c) Hyperglycemia-induced inhibition of insulin receptor signaling
ll ll ll ll ll ll ll
d) Dysregulation of hepatic glucose production - CORRECT-ANSWERS b) impaired
ll ll ll ll ll ll ll ll ll ll ll ll
glucose uptake by peripheral tissues
ll ll ll ll ll
Which of the following pathophysiological mechanisms is associated with the
ll ll ll ll ll ll ll ll ll
development of peptic ulcer disease?
ll ll ll ll ll ll
a) Excessive production of gastric acid by parietal cells
ll ll ll ll ll ll ll ll ll
b) Impaired mucosal blood flow leading to ischemia
ll ll ll ll ll ll ll ll
c) Chronic inflammation and infection with Helicobacter pylori
ll ll ll ll ll ll ll ll
d) Dysfunction of the lower esophageal sphincter allowing reflux of gastric contents -
ll ll ll ll ll ll ll ll ll ll ll ll
CORRECT-ANSWERS c) chronic inflammation and infection with H. pylori
ll ll ll ll ll ll ll ll ll ll ll ll
What is the primary pathophysiological mechanism underlying Alzheimer's disease?
ll ll ll ll ll ll ll ll ll
, a) Accumulation of amyloid plaques and neurofibrillary tangles in the brain
ll ll ll ll ll ll ll ll ll ll ll
b) Degeneration of motor neurons in the spinal cord
ll ll ll ll ll ll ll ll ll
c) Impaired transmission of acetylcholine at the neuromuscular junction
ll ll ll ll ll ll ll ll ll
d) Blockage of cerebral blood vessels by thrombi or emboli - CORRECT-ANSWERS a)
ll ll ll ll ll ll ll ll ll ll ll ll ll ll ll
accumulation of amyloid plaques and neurofibrillary tangles in the brain
ll ll ll ll ll ll ll ll ll ll
What is the primary cause of cystic fibrosis?
ll ll ll ll ll ll ll ll
a) Autoimmune destruction of pancreatic beta cells
ll ll ll ll ll ll ll
b) Excessive production of mucus by bronchial glands
ll ll ll ll ll ll ll ll
c) Mutations in the CFTR gene leading to defective chloride ion transport
ll ll ll ll ll ll ll ll ll ll ll ll
d) Chronic exposure to tobacco smoke and environmental pollutants - CORRECT-
ll ll ll ll ll ll ll ll ll ll
ANSWERS c) mutations in the CFTR gene leading to defective chloride ion transport
ll ll ll ll ll ll ll ll ll ll ll ll ll ll ll
What is the primary pathophysiological mechanism underlying Parkinson's disease?
ll ll ll ll ll ll ll ll ll
a) Degeneration of dopaminergic neurons in the substantia nigra of the brain
ll ll ll ll ll ll ll ll ll ll ll ll
b) Impaired transmission of serotonin in the spinal cord
ll ll ll ll ll ll ll ll ll
c) Accumulation of tau protein aggregates in the cerebral cortex
ll ll ll ll ll ll ll ll ll ll
d) Blockage of cerebral blood vessels by atherosclerotic plaques - CORRECT-
ll ll ll ll ll ll ll ll ll ll
ANSWERS a) degeneration of dopaminergic neurons in the substantia nigra of the
ll ll ll ll ll ll ll ll ll ll ll ll ll ll
brain
ll
Which of the following pathophysiological mechanisms is associated with the
ll ll ll ll ll ll ll ll ll
development of osteoporosis?
ll ll ll ll
a) Excessive production of parathyroid hormone leading to bone resorption
ll ll ll ll ll ll ll ll ll ll
b) Decreased synthesis of collagen by osteoblasts
ll ll ll ll ll ll ll
c) Impaired blood supply to bone tissues causing necrosis
ll ll ll ll ll ll ll ll ll
